Unmet Need for Primary Health Care for Children in Northland compared to New Zealand*

2014 - 2017

What is it?The indicator shows the prevalence of unmet need for primary care for children, aged 0-15 years, living in Northland compared to New Zealand as a whole, between 2014 and 2017.
The shaded area represents the 95% confidence interval for each estimate†.

Why is it important?Patients’ ability to access primary care and the quality of care they receive has an impact on their health outcomes. Understanding the challenge Northland children experience in accessing primary care services is important to identify how we can act to improve health outcomes.

What does this mean for Northland?30% of children living in Northland experienced difficulty in accessing primary care in the last year (2017), a 10% increase since 2014. Barriers to accessing primary care were significantly higher for children in Northland compared to New Zealand (30% compared to 20% respectively).

*New Zealand Health Survey, Children, Barriers to Accessing in Health Care 2014-2017 (age-standardised), Ministry of Health. † A 95% confidence interval is a range of values that one can be 95% certain contains the true mean or proportion of the population.

Unmet Need for Primary Health Care Reported by Adults in Northland compared to New Zealand*

2014 - 2017

What is it?The indicator shows the prevalence of unmet need for primary care for adults (aged 15 years and older), living in Northland compared to New Zealand as a whole, between 2014 and 2017.
The shaded area represents the 95% confidence interval for each estimate†.

Why is it important?Primary care is the first point of contact to health services, providing comprehensive care based in the patient’s community. Patients’ ability to access primary care and the quality of care they receive has an impact on their health outcomes. It is important to understand the challenges Northland residents face in accessing primary care services.

What does this mean for Northland?In 2017, 33% of adults living in Northland experienced some degree of unmet need when accessing primary care services, an 8% increase from 2014. Adults living in Northland experienced greater challenges in accessing primary care compared to New Zealand as a whole (29%).

*New Zealand Health Survey, Adults, Barriers to Accessing in Health Care 2014-2017 (age-standardised), Ministry of Health. † A 95% confidence interval is a range of values that one can be 95% certain contains the true mean or proportion of the population.

Barriers to Accessing Primary Health Care for Children in Northland*

2014 - 2017

What is it?The indicator shows the main reasons for unmet need in primary care for children (aged 0-15 years) living in Northland 2014 to 2017.

Why is it important?Understanding the barriers our population experience when accessing primary care is useful to identify where we might intervene to improve health outcomes.

What does this mean for Northland?The relative importance of the barriers children in Northland were facing when accessing primary care have changed from 2014 to 2017. The proportion of those who have difficulty accessing a GP due to transport increased from 1 % in 2014 to 12 % in 2017, to become the second most prevalent barrier to care for children in Northland. The inability to get an appointment within 24 hours, and difficulty accessing a GP due to cost still remain the main barriers to care for children living in Northland.

Barriers to Accessing Primary Health Care for Adults in Northland*

2014 - 2017

What is it?The indicator shows the main reasons for unmet need for primary care in Northlanders, aged 15 years and older, from 2014 to 2017.

Why is it important?Understanding the barriers our population experience when accessing primary care is useful to identify how we might intervene to improve health outcomes.

What does this mean for Northland?The three main barriers Northlanders faced when accessing primary care were; the inability to get an appointment within 24 hours, difficulty accessing a General Practitioner due to cost, and being unable to fill a prescription due to cost. The inability to access a timely appointment appeared to be the most significant barrier in 2017, with 24% of Northland adults reporting this as an issue.

2011-2014

What is it?The indicator explores the barriers to accessing primary care for Northland Māori compared to Northland non- Māori (aged 15 years and older) between 2011 and 2014.

Why is it important?Primary care is important in maintaining our health and wellbeing, and for managing health conditions in the community. Early detection and treatment of health issues in primary care can help keep people out of the hospital. Differences in the barriers to accessing health services in subpopulation groups helps to identify areas where we might intervene to reduce inequalities in health outcomes.

What does this mean for Northland?The three top barriers to accessing primary health care in Northland were: an inability to get an appointment within 24 hours, the inability to see a General Practitioner due to cost, and having unfilled prescriptions due to cost. Overall, Northlanders identifying as Māori were 50% more likely to have difficulty accessing primary care compared to their non-Māori peers. Cost contributed to two of the three main challenges.

There were significant differences in the barriers to accessing care due to cost between those identifying as Māori and non- Māori. Northland Māori were 4 times more likely to forgo filling a prescription due to cost compared to non-Māori in Northland, and were more than 2.5 times more likely to be unable to attend a GP because of cost.

Immunisation at 8 months of Age, Northland*

2014 - 2017

What is it?The indicator shows the percentage of infants living in Northland who are up-to-date with their scheduled immunisations at 8 months of age. The graph shows the trend in immunisation coverage from 2014 to 2017, as well as the Ministry of Health target for that time period.

Why is it important?Childhood immunisations provide protection from a number of serious illnesses such as measles, mumps, diphtheria and whooping cough. Immunisation is the most effective way of preventing these infectious conditions. A lower rate of immunisation coverage leads to a greater risk of an infectious disease outbreak in the wider population. The Ministry of Health aim is for all District Health Boards to have 95% of their regions’ infants up-to-date with their scheduled immunisations at 8 months of age.

What does this mean for Northland?In 2017, 86% of children in Northland identifying as Māori, and 85% of European children were fully immunised at 8 months of age, which fell well short of the 95% target set by the Ministry of Health in 2017.

Emergency Department Use by Children in Northland*

2014 - 2017

What is it?The indicator shows the percentage of Northland children, aged 0 -14 years old, who have used the emergency department (ED) at least once in the 12 months prior. The graph shows the trend in the use of ED services from 2014 to 2017. The shaded area represents the 95% confidence interval for each estimate†.

Why is it important?ED use can provide an indication of unmet need for primary health services, reflecting the ability (or inability) to access appointments with a General Practitioner (GP), or after-hours care. The cost of GP services or after-hour care also influences the decision to visit the ED.

What does this mean for Northland?The percentage of children living in Northland who have used the ED in the 12 months prior to being surveyed has remained consistent over time, with no significant difference noted from 2014 (20%) to 2017 (14%). ED use for children in Northland was comparable with that in New Zealand children as a whole.

Did you know?

General practice (GP) services are free for children under 13, and this support will soon extended to under 14 year olds (estimated December 2018). Children under 13 can visit their GP or practice nurse during the day at their usual practice or during after-hours at some participating clinics for no charge.

Resource source: Ministry of Health

Source credit: Ministry of Health, New Zealand

*New Zealand Health Survey , Children, ED Use 2013/14-2016/17, Ministry of Health. † A 95% confidence interval is a range of values that one can be 95% certain contains the true mean or proportion of the population.

Emergency Department Use by Adults in Northland*

2014 - 2017

What is it?The indicator shows the percentage of adults living in Northland who have used the emergency department (ED) for their own health needs, at least once in the 12 months prior. The graph shows the trend in the use of ED services from 2014 to 2017. The shaded area represents values that are within the 95% confidence interval†.

Why is it important?ED use can provide an indication of unmet need for primary health services, reflecting the ability (or inability) to access appointments with a General Practitioner (GP), or after-hours care. The cost of GP services or after-hour care also influences the decision to visit the Emergency Department.

What does this mean for Northland?The percentage of adults living in Northland who have visited the ED in the last 12 months has remained consistent, with no significant difference noted from 2014 (16%) to 2017 (17%). ED use for adults in Northland was also comparable with ED use for New Zealand as a whole.

*New Zealand Health Survey, Adults, ED Use 2013/14-2016/17 (age-standardised), Ministry of Health. † A 95% confidence interval is a range of values that one can be 95% certain contains the true mean or proportion of the population

Appropriate Treatment for Asthma by Ethnicity*

2014

What is it?The indicator shows the percentage of those living in Northland (aged 5 years and older) who have been dispensed a reliever Short-Acting Beta Antagonist (SABA), but not a ‘preventer’, Inhaled Corticosteroids (ICS), for the management of asthma in the year 2014. The information is also displayed by ethnicity.

Why is it important?Best practice for asthma management suggests that those having symptoms more than twice a week should use asthma preventer, as well as a reliever. Using a preventer can help avoid some exacerbations of asthma, and the need for visits to the doctor or hospital.

What does this mean for Northland?In 2014, Northlanders and New Zealand as a whole were comparable in receiving a reliever (33% compared to 31% respectively). There was no significant difference between Northlanders identifying as Māori, who received only a reliever as management of their asthma, compared to non- Māori.

Did you know?

As well as receiving the correct pharmaceutical treatment for asthma, there are a number of things that can be done to keep your asthma in check.

‘Triple Therapy’ Care for Adults with Cardiovascular Disease in Northland*

2017

What is it?The indicator shows the percentage of Northland adults with Cardiovascular Disease (CVD) aged 30 to 80 years old who are receiving triple therapy to manage their condition.

Why is it important?The appropriate medical management of patients with CVD can reduce the risk of serious future cardiovascular events (such as heart attack), and improve overall health outcomes. Clinical evidence suggests the use of statins, antiplatelet (or anticoagulant), and hypertensive drugs as secondary prevention measures in patients with known CVD.

The current guideline is for patients with a certain level of risk to receive ‘triple therapy’. The National Cardiac Network has agreed upon a treatment targets, where 85% of patients with known CVD are receiving a statin, and 70% are receiving all three therapies (triple therapy).

What does this mean for Northland?Fewer adults in Northland living with known CVD were receiving these therapies when compared to New Zealand as a whole. 63% of Northlanders were receiving only statins, and 53 % were prescribed all three therapies to manage their CVD, compared to 68% and 58% respectively for New Zealand as a whole.

Northland District Health Board, or any other DHB in New Zealand, has not reached the target of 85% of patients receiving statins and 70% receiving triple therapy as the appropriate medical management to prevent future CVD events.